| Id |
Subject |
Object |
Predicate |
Lexical cue |
| T1 |
0-86 |
Sentence |
denotes |
Recommendations for anesthesia in patients suspected of COVID-19 Coronavirus infection |
| T2 |
87-123 |
Sentence |
denotes |
Anesthesia for Coronavirus Infection |
| T3 |
125-397 |
Sentence |
denotes |
The following guidelines are based on recommendations from the Anesthesia Patient Safety Foundation (APSF) for working with patients who have COVID-19 [1] and the other literature [2-5], and can be modified and adapted to the circumstances of each institution or hospital. |
| T4 |
398-542 |
Sentence |
denotes |
When managing patients with confirmed or suspected COVID-19 infection, it is of utmost importance to protect health care workers from infection. |
| T5 |
543-665 |
Sentence |
denotes |
All medical personnel must be provided with personal protective equipment (PPE) to prevent droplet and contact infections. |
| T6 |
666-764 |
Sentence |
denotes |
Medical staff and institutions should establish procedural protocols for donning and removing PPE. |
| T7 |
765-951 |
Sentence |
denotes |
Prior to patient treatment, staff must identify and review the in-hospital procedural protocols, and plan ahead for patient transfer, anesthesia work environment, and anesthesia methods. |
| T8 |
953-1003 |
Sentence |
denotes |
Patient transport and operating room managing plan |
| T9 |
1004-1056 |
Sentence |
denotes |
• Do not allow patients to stay in the holding area. |
| T10 |
1057-1141 |
Sentence |
denotes |
Treatment should be carried out in a pre-allocated negative pressure operating room. |
| T11 |
1142-1254 |
Sentence |
denotes |
Warning signs for COVID-19 infection should be posted in front of the operating room to minimize staff exposure. |
| T12 |
1255-1330 |
Sentence |
denotes |
• Patients should not stay in the recovery room or postoperative care unit. |
| T13 |
1331-1481 |
Sentence |
denotes |
After complete recovery in the operating room, the patient should be transferred into a negative pressure room in a ward or intensive care unit (ICU). |
| T14 |
1482-1636 |
Sentence |
denotes |
• Endotracheal intubation, tube exchange, and extubation are high-risk procedures that can expose healthcare workers to respiratory droplets of the virus. |
| T15 |
1637-1788 |
Sentence |
denotes |
These procedures must be carried out in a location where negative pressure is applied such as negative pressure room, and special care should be taken. |
| T16 |
1789-1973 |
Sentence |
denotes |
• Depending on the clinical situation, performing an endotracheal intubation early in a negative pressure room in a ward or ICU, rather than in an operating room, should be considered. |
| T17 |
1974-2172 |
Sentence |
denotes |
• If it is determined that the degree of negative pressure in the environment is not sufficient, the additional application of a portable high-efficiency particulate air filter should be considered. |
| T18 |
2173-2369 |
Sentence |
denotes |
• A highly efficient hydrophobic filter should be placed between the endotracheal tube and the reservoir bag, to prevent atmospheric contamination by respiratory droplets during patient transfers. |
| T19 |
2371-2389 |
Sentence |
denotes |
Anesthesia Process |
| T20 |
2391-2393 |
Sentence |
denotes |
1. |
| T21 |
2394-2417 |
Sentence |
denotes |
Preparation of manpower |
| T22 |
2418-2526 |
Sentence |
denotes |
• Assign the most experienced anesthesia professionals to practitioners performing endotracheal intubations. |
| T23 |
2527-2615 |
Sentence |
denotes |
Inexperienced trainees should not perform endotracheal intubation for training purposes. |
| T24 |
2616-2747 |
Sentence |
denotes |
• Assign experienced assistants who can perform techniques such as cricoid pressure when performing rapid sequence induction (RSI). |
| T25 |
2748-2843 |
Sentence |
denotes |
• Consider allowing anesthesia teams to be replaced at least every 2 hours, to prevent fatigue. |
| T26 |
2845-2847 |
Sentence |
denotes |
2. |
| T27 |
2848-2918 |
Sentence |
denotes |
Preparation before anesthesia and use of personal protective equipment |
| T28 |
2919-2977 |
Sentence |
denotes |
• Allow sufficient time for all staff involved to don PPE. |
| T29 |
2978-3031 |
Sentence |
denotes |
It may take more than 5 minutes to properly wear PPE. |
| T30 |
3032-3116 |
Sentence |
denotes |
• Early planning and implementation of endotracheal intubation should be considered. |
| T31 |
3117-3281 |
Sentence |
denotes |
In the event of an unexpected emergency endotracheal intubation, PPE cannot be adequately donned; therefore, early implementation should be performed when possible. |
| T32 |
3282-3419 |
Sentence |
denotes |
• Protective coverall/body suits, N95 masks, disposable goggles/face shields, disposable shoe covers, and disposable gloves must be worn. |
| T33 |
3420-3483 |
Sentence |
denotes |
Use the double glove technique on both hands to reduce contact. |
| T34 |
3484-3626 |
Sentence |
denotes |
• A powered air-purifying respirator should be worn by healthcare workers who are involved in endotracheal intubation or extubation processes. |
| T35 |
3628-3630 |
Sentence |
denotes |
3. |
| T36 |
3631-3664 |
Sentence |
denotes |
Selection of intubation technique |
| T37 |
3665-3755 |
Sentence |
denotes |
• Awake fiberoptic intubation should not be performed unless it is a necessary indication. |
| T38 |
3756-3831 |
Sentence |
denotes |
Spraying local anesthetics can aerosolize the virus, and should be avoided. |
| T39 |
3832-3934 |
Sentence |
denotes |
• Consider using video laryngoscopes to increase the likelihood of successful endotracheal intubation. |
| T40 |
3935-3986 |
Sentence |
denotes |
• Consider using disposable devices for intubation. |
| T41 |
3988-3990 |
Sentence |
denotes |
4. |
| T42 |
3991-4014 |
Sentence |
denotes |
Endotracheal intubation |
| T43 |
4015-4166 |
Sentence |
denotes |
• A high-efficiency hydrophobic filter must be applied between the face mask and the breathing circuit, or between the face mask and the reservoir bag. |
| T44 |
4167-4235 |
Sentence |
denotes |
• Preoxygenation for 5 minutes with 100% oxygen should be performed. |
| T45 |
4236-4359 |
Sentence |
denotes |
• RSI should be performed to limit procedures such as manual ventilation, which can spread aerosolized virus into the room. |
| T46 |
4360-4427 |
Sentence |
denotes |
• The method of RSI can be modified to suit the clinical situation. |
| T47 |
4428-4615 |
Sentence |
denotes |
If manual ventilation is required, a small tidal volume may be considered, or a supraglottic airway may be inserted to provide ventilation instead of manual ventilation using a face mask. |
| T48 |
4616-4722 |
Sentence |
denotes |
• Do not use high-flow oxygen, such as high-flow nasal cannula devices, as these can aerosolize the virus. |
| T49 |
4724-4726 |
Sentence |
denotes |
5. |
| T50 |
4727-4777 |
Sentence |
denotes |
Equipment management after endotracheal intubation |
| T51 |
4778-4898 |
Sentence |
denotes |
• All used airway equipment should be placed in double zip-locked plastic bags and removed for disposal or disinfection. |
| T52 |
4899-5076 |
Sentence |
denotes |
• Used laryngoscopes should be sealed in double zip-locked plastic bags as soon as the endotracheal intubation is complete, to prevent further contamination of the surroundings. |
| T53 |
5077-5146 |
Sentence |
denotes |
• End-tidal carbon dioxide sample lines and traps should be replaced. |
| T54 |
5147-5268 |
Sentence |
denotes |
• Take care to avoid contaminating various instruments in the operating room, such as stethoscopes, pens, and telephones. |
| T55 |
5270-5272 |
Sentence |
denotes |
6. |
| T56 |
5273-5330 |
Sentence |
denotes |
Undressing and hand washing after endotracheal intubation |
| T57 |
5331-5485 |
Sentence |
denotes |
• Consider preparing additional isolation rooms as contaminated areas next to the operating room to remove and dispose of PPE in accordance with protocol. |
| T58 |
5486-5648 |
Sentence |
denotes |
If it is difficult to obtain an additional isolation room, use the space inside or immediately outside the operating room to remove PPE according to the protocol. |
| T59 |
5649-5686 |
Sentence |
denotes |
• Wash your hands after removing PPE. |
| T60 |
5687-5770 |
Sentence |
denotes |
• Avoid body contact, including touching your hair or face, until hands are washed. |
| T61 |
5772-6720 |
Sentence |
denotes |
We thank the members of Scientific Committee in the Korean Society of Anesthesiologists; Eun-Ho Lee (University of Ulsan College of Medicine, Seoul), Hyungseok Seo (Kyung Hee University College of Medicine, Seoul), Sun Young Park (Soonchunhyang University College of Medicine, Seoul), Jin-Tae Kim (Seoul National University College of Medicine, Seoul), Seo-kyung Shin (Yonsei University College of Medicine, Seoul), Jinseok Yeo (Kyungpook National University School of Medicine, Daegu), Dong-Kyu Lee (Korea University College of Medicine, Seoul), Jong-Hwan Lee (Sungkyunkwan University School of Medicine, Seoul), WooSuk Chung (Chungnam National University College of Medicine, Daejeon), Geun Joo Choi (Chung-Ang University College of Medicine, Seoul), Jae Hee Woo (Ewha Womans University College of Medicine, Seoul), Ji Su Jang (Hallym University College of Medicine, Chuncheon), Ah-Reum Cho (Pusan National University College of Medicine, Busan). |
| T62 |
6721-6742 |
Sentence |
denotes |
Conflicts of Interest |
| T63 |
6743-6815 |
Sentence |
denotes |
No potential conflict of interest relevant to this article was reported. |
| T64 |
6816-6836 |
Sentence |
denotes |
Author Contributions |
| T65 |
6837-6968 |
Sentence |
denotes |
Hyun Joo Kim (Investigation; Project administration; Supervision; Validation; Writing – original draft; Writing – review & editing) |
| T66 |
6969-7054 |
Sentence |
denotes |
Justin Sangwook Ko (Validation; Writing – original draft; Writing – review & editing) |
| T67 |
7055-7175 |
Sentence |
denotes |
Tae-Yop Kim (Conceptualization; Project administration; Resources; Writing – original draft; Writing – review & editing) |